Obamacare - Available but not Affordable, Despite the Obama Spin

The Affordable Care Act, President Obama told a large audience of Catholic healthcare professionals, "is no longer just a piece of legislation or an abstract theory, but a reality that people on the ground, day to day, are experiencing. Their lives are better,...Americans support this new reality,” Obama said. Republicans were quick to counter the President’s speech, saying the President was divorced from reality and denying the negative effects of a health care overhaul they said had raised costs and caused some people to lose health coverage they liked. ~~~~~ Last week, Brianna Ehley of the Fiscal Times provided some numbers for Obamacare’s final tally for this year’s open enrollment period in which some 10 million people purchased health coverage through Obamacare’s state and federal exchanges -- surpassing the administration’s goal of 9.5 million enrollees. While that part of the news is good for Mr. Obama, here’s a snapshot of Obamacare and health insurance in the US in 2015 which suggests that the law's opponents are right : ** 150 million Americans get their health insurance through an employer. ** 70 million people get health coverage through Medicaid or the Children’s Health Insurance Program (CHIP) after 30 states expanded their Medicaid programs under Obamacare. ** 16.4 million people have gained health coverage through Obamacare, whether through the law’s health exchanges or Medicaid expansion, according to March figures from the Obama administration. ** 10.2 million Obamacare 2015 enrollees paid for their premiums in the first month. ** 1.5 million Obamacare 2015 enrollees didn’t pay for their premiums in the first month. ** 2.3 million young adults gained coverage this year through an Obamacare provision that allows them to stay on their parent’s plan until they reach 26 years in age. ** 11.9% is the current uninsured rate, the lowest ever recorded by Gallup, who attributes the record-low uninsured rate to the health exchanges and Medicaid expansion set up under Obamacare. ** 31 million Americans with insurance say they still can’t afford medical treatment, and are considered “underinsured” because they are enrolled in high-deductible policies with high out of pocket costs. And a recent Gallup poll shows that about 38% of middle class people with a household income of $30,000 to $75,000 per year have delayed medical care because of costs, up from 33% last year. Meanwhile, about 28% of households earning above $75,000 said they delayed care this year, compared to just 17% in 2013. ~~~~~ The embarrassng truth never spoken by President Obama is that while the Affordable Care Act has reduced the uninsured rate to historic lows, it has not expanded actual access to healthcare. ~~~~~ First, there are the many working poor Americans who still can’t afford health coverage and so delay medical treatment. Many of the working poor rely heavily on community health centers -- exclusively designed for uninsured people and those with coverage through Medicaid. Obamacare provided more funding to these community health centers. And in May, the Obama administration announced $101 million to build 164 new health centers in 33 states and two US territories in order to increase access to services for about 650,000 patients, while existing centers also received federal funding to expand. The federal government funds the centers on a sliding scale for uninsured low income people, and provides Medicaid reimbursements for patients on Medicaid. Obamacare was touted as being able to reduce the number of patients using these community health centers, but the truth is that many of the centers are actually receiving more patients. A George Washington University study found that more than one million low-income, uninsured Americans depend on community health centers and that about 35% of these people live in Alabama, Florida, Georgia, Louisiana and Mississippi -- states that have not expanded their Medicaid programs. ~~~~~ Second, a 2012 Supreme Court ruling decided that states could opt out of Obamacare's Medicaid expansion, which expanded eligibility to every childless adult earning up to 138% of the federal poverty level, regardless of their ability to work. The ruling created a so-called “coverage gap” in the 21 states that decided not to expand their programs. The people in the gap earn too much to qualify for Medicaid, but not enough to qualify for subsidies on the state or federal health exchanges. Many of them turn to community health centers because their options for coverage are limited. ~~~~~ And, third, even in states that did expand Medicaid, there are still many people who can’t afford to buy coverage, or can only afford to buy coverage with high out-of-pocket costs -- for example, $5,181 for many Bronze plans. A recent study from the Commonwealth Fund found that 23%, that is 31 million, Americans with health coverage fall into this category. Community health centers also fill in these gaps where Obamacare doesn’t provide care for people. Many patients going to centers are uninsured for now, but there is a penalty for not having Obamacare coverage. Last year, the penalty was just $95 or 1% of annual income. In 2015, the penalty went up to $323 or 2% of annual income. The penalty will gradually increase. And those not having healthcare insurance because it's far less expensive than the actual costs of obtaining coverage for many low to middle-income families -- convincing some to opt out of Obamacare -- will find that as the penalty increases each year, it could become a huge financial burden. ~~~~~ So, dear readers, the problem with Obamacare is that it’s available but not affordable for the many Americans who use community care centers instead. There are millions of Americans who rely on community health centers even now that the uninsured rate has fallen to historic lows. That’s because high deductible policies and out-of-pocket costs still prevent people from actually being able to cover the cost of treatment. A Gallup poll late last year reported that about one in three Americans say they have put off treatment for themselves or a family member because of cost -- this is the highest rate recorded in Gallup’s history. Gallup attributed the increase to the shift to high-deductible policies being sold both on and off the Obamacare exchanges. Tom Scully, former CMS administrator under President George H.W. Bush noted during a Wall Street Journal breakfast last week : “It’s important to distinguish between coverage and access to care...there is still a problem with access. It’s sobering how many people don’t have the resources to cover $200 emergency costs and still don’t have access to care when they need it.” And if all this weren't enough, a recent Gallup poll found that the cost of healthcare is only expected to climb -- that's right. A new report from PricewaterhouseCooper’s Health Research Institute says health care costs are expected to jump 6.8% overall next year. Therefore, as costs rise it’s likely that more people will continue to put off needed care. Thank you, President Obama, for ruining the American healthcare system without doing anything to give healthcare to Americans who need it. America would have supported that goal. As it is, and despite the best spin you can put on the situation, 55% of Americans oppose your failure that is Obamacare.